PDF(Pubmed)
Abstract：
Background Zinc, an essential trace element, plays a vital role in cellular metabolism, and the liver is the main organ responsible for its metabolism. Because serum zinc levels are found to be lowered in chronic liver diseases, it has been hypothesized to be a precipitating factor for the development of hepatic encephalopathy. Methodology This prospective, observational study included patients with decompensated cirrhosis of the liver who were admitted to the medical intensive care unit of a tertiary care institute in northern India between September 2021 and April 2023. The diagnosis was based on history and detailed clinical examination. The serum zinc levels of patients were estimated using atomic absorption spectrometry at admission and compared to that of healthy controls. Serum zinc levels were correlated with the severity of liver disease and hepatic encephalopathy among the cases. Results A total of 100 cases of decompensated cirrhosis of the liver and 50 healthy controls were included. The mean serum zinc level of the cases was 40.5 ± 10.0 µg/dL which was significantly lower than the mean serum zinc level (104.0±9.1 µg/dL) of controls (p < 0.0001). Serum zinc level was significantly lower in patients with higher grades of hepatic encephalopathy (p = 0.000). Similarly, serum zinc level was significantly reduced among patients with higher Child-Pugh and Model for End-stage Liver Disease scores. Conclusions Serum zinc level is significantly reduced in patients with decompensated cirrhosis of the liver, and lower serum zinc level is associated with the increased severity of the disease and higher grades of hepatic encephalopathy. In patients with decompensated cirrhosis of the liver, maintenance of adequate serum zinc levels may prevent hepatic encephalopathy.
摘要：
背景锌，一种必需的微量元素，在细胞代谢中起着至关重要的作用，肝脏是负责其新陈代谢的主要器官。因为慢性肝病患者血清锌水平降低,据推测，它是肝性脑病发展的诱因。方法论这个前瞻性的，观察性研究纳入了2021年9月至2023年4月期间入住印度北部三级医疗机构医疗重症监护室的失代偿期肝硬化患者.诊断基于病史和详细的临床检查。入院时使用原子吸收光谱法估算患者的血清锌水平，并与健康对照组进行比较。血清锌水平与肝病和肝性脑病的严重程度相关。结果共纳入100例失代偿期肝硬化患者和50例健康对照者。这些病例的平均血清锌水平为40.5±10.0µg/dL，显着低于对照组的平均血清锌水平（104.0±9.1µg/dL）（p<0.0001）。肝性脑病患者血清锌水平显著降低(p=0.000)。同样，Child-Pugh和终末期肝病模型评分较高的患者血清锌水平显著降低.结论肝硬化失代偿期患者血清锌水平明显降低,较低的血清锌水平与疾病的严重程度增加和肝性脑病的严重程度增加有关。在肝硬化失代偿期患者中，维持足够的血清锌水平可以预防肝性脑病。
